Individual
DANIEL B TEAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2627 RIVERSIDE AVE, SUITE 300, JACKSONVILLE, FL 32204-4712
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K1374
MEDICARE GROUP#
FL
01
—
Y904L
BCBS PROVIDER#
FL
Enumeration date
05/11/2006
Last updated
06/20/2025
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